Impact of oral contraceptives on sex hormone-binding globulin and androgen levels: a retrospective study in women with sexual dysfunction.
Level 3 - non-randomized controlled study
Retrospective non-randomized comparative cohort study
PubMed 16409223 · doi:10.1111/j.1743-6109.2005.00198.x
What was done
A retrospective comparative study evaluated sex hormone-binding globulin (SHBG) levels in 124 premenopausal women presenting with sexual health complaints for more than 6 months. Participants were divided into three groups: Continued-Users (n = 62, mean age 32) who had taken oral contraceptives (OCs) for >6 months and continued; Discontinued-Users (n = 39, mean age 33) who had taken OCs for >6 months and stopped; and Never-Users (n = 23, mean age 36). SHBG was evaluated during OC use and after discontinuation at 49–120 days (mean 80 days) and >120 days (mean 196 days).
What was found
SHBG values in Continued-Users were roughly four-fold higher than in Never-Users (mean 157 ± 13 nmol/L vs. 41 ± 4 nmol/L; P < 0.0001). While SHBG decreased after stopping OCs, levels in Discontinued-Users remained significantly higher than in Never-Users beyond 120 days post-discontinuation (n = 26; P < 0.0001). The abstract did not report absolute numerical SHBG values for the Discontinued-Users or report androgen concentrations.
Why it matters
This study suggests that OC-induced elevations in SHBG may persist for months after stopping the pill, offering a potential hormonal mechanism for persistent sexual dysfunction in some women.
Limits
The sample was restricted to women seeking care for sexual health complaints, limiting generalizability to the broader population of OC users. The retrospective design lacks baseline pre-OC hormone measurements, does not specify the OC formulations used, lacks numerical SHBG and androgen values in the abstract for the discontinued group, and cannot prove long-term causality or gene expression changes.
Cited by
- context Oral contraceptive use increases sex hormone-binding globulin (SHBG) levels in women long-term.